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o`: = p h��•b CITY OF PRIOR LAKE BUII :DING PERMIT, Date Recd
f ' � `` TEMPORARY CERTIFICATE OF ZONING COMPLIANCE / . ,/ / /
4U / 6 AND UTILITY CONNECTION PERMIT t<
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2 k G y PERMIT NO. / I <, , :/
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1 \oleo npplicri:
I Plcasc type VT print and in at bottom) _
ADDRESS ' ZO\1NC+ (office wc)
158"Z1 Jjam View kd• tJ (1J ._
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LEGAL DESCRIPTION tr:t;icc ilk cniy)
LOT BLOCK. ADDITION PID .........
OWNER r(�
(Name) . .e►2 —V ( :h Z- (Phone)
(Address) Saldbt:€ 4 c&j3t ■le
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(Company N me ���j U-�nC VOC er0 a rS n �` r- (Phone) r � 5j -5 (p2 --it i o a
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(Contact Name) 2116 1 --AVV 1 -01AC u y or. I 1 (Phone)
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,�d�ress; 11535,
TYPE OF'VCORK ❑mctvv Cc:ism:ena: DD :cl: DPorcb Dire- Roofing Cate - Siding DLower Level Finish ❑ Fireplace
DAdditioo ❑Attcraticn ❑liiiity Connection ,
CODE: LT,.R.C. 01.13.C. [pisc .1) ar- d.ra -h le 6Listes'I -'1.
Typc of Construction: 1 II UT TV V A B WI $l? 1'1+1 e 2.t `}-
Occupancv Group: A B E F III MR S U PROTECT' COST /VALUE $ L I f 1 C) • 6 °
Division: 1 2 3 4. 5 (e.xcludi Ir. land)
I hcrcty cc'dfj that I hrvc fits ished information on this n p': cat;nn which it a the gosh of ^ty knowle tpc rru_ and correct. I also cer.114 t.'te.t 1 e.m Etc oWncr tr antherlacd agent for the
strive- ircrtionca tau ^cr rid that nu eons&- ion will conform to all c:<irtntr start ,:,d 1 <x-ai :aws Tad will proceed in accordance wi:1z ruhmi7id plans. 1 tan &ware :h?+ the bulfding
c.„,,,: can rev�_1tc tail i.. just eau. ittcrratat, t hereby agree tart: the city offiicia, or, dr5s!A e . any crier upon the property to perform necdod inspenicn.t.
Signature - Cola actar's License No. Date
Perm Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee W $ Water Meter Size 5 /8"; P; I S
State Surcharge Pressure Reducer S
Pcrahy $ Sewer/Wt.ter Conrectin Pee # S
1 Permit Fee $ Water Tower Fee = $
Mechanics: Permit Fee $ . w Builder's Deposit S
Sever & Water Permit Pc:: I' C,:!acr I S
Gas Fireplece PcrmitFre $ i TOTAL DUE $ 7t7, '7
This Application Becomes Your Btrildin g Permit 'Si"Ihcn Approve A Paid - 7q, "?_S R e cc iptNo, 6_3,i...57
If zy i� Date Go . ze, I1 B
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13G:linz0`15cf : Da:e
Ti ',■;: i> co certify that the toques: in the ahvv= applient or. cad aceotnpartyat5 ttceaments it in accordance with the City Zoning ChGnr.nee and inn proceed as requcstrd, This doeanene
waen si1ocd lay Olt City Planner conclann e ternporrey CCr :ihTtC of Zrning e;tnpliance Aral allows eanitracion ro m. *&&lace. Reforc occvpancy. & Certificate of Ocupaney rust. cc
:CC;7ed.
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PI mining Dit:ctor . tc - Sp:tit1 C ndilitrs, if an., -°
24 hoar antics for all Inspections (952) 447 -9850. fax (952) 447.42.15
4646 Dakota StreetS,E, Prior Lake. Minnesota 55372
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Builder ID :+20636116 ' +. , ,; ;: ; °. c „ ;;+ ';'t4 „ :' 1 . , ; � ' N +Ir: ,3...�:isS :� ` '` ' ' 1 i•ui
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Comments:
Pl ease process the attached building perm app'ication. Please call when the permit is processed
a nd I will make a credit card payment over the phone or serd in a check.
Thank you,
Kari Johnson
,